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Koehler P, Hamprecht A, Bader O, Bekeredjian-Ding I, Buchheidt D, Doelken G, Elias J, Haase G, Hahn-Ast C, Karthaus M, Kekulé A, Keller P, Kiehl M, Krause SW, Krämer C, Neumann S, Rohde H, La Rosée P, Ruhnke M, Schafhausen P, Schalk E, Schulz K, Schwartz S, Silling G, Staib P, Ullmann A, Vergoulidou M, Weber T, Cornely OA, Vehreschild MJGT. Epidemiology of invasive aspergillosis and azole resistance in patients with acute leukaemia: the SEPIA Study. Int J Antimicrob Agents 2016; 49:218-223. [PMID: 27989379 DOI: 10.1016/j.ijantimicag.2016.10.019] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/25/2016] [Accepted: 10/12/2016] [Indexed: 10/20/2022]
Abstract
Invasive aspergillosis (IA) is a serious hazard to high-risk haematological patients. There are increasing reports of azole-resistant Aspergillus spp. This study assessed the epidemiology of IA and azole-resistant Aspergillus spp. in patients with acute leukaemia in Germany. A prospective multicentre cohort study was performed in German haematology/oncology centres. The incidence of probable and proven aspergillosis according to the revised EORTC/MSG criteria was assessed for all patients with acute leukaemia [acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL)]. Cases were documented into a web-based case report form, and centres provided data on standards regarding prophylactic and diagnostic measures. Clinical isolates were screened centrally for azole resistance and, if applicable, underlying resistance mechanisms were analysed. Between September 2011 and December 2013, 179 cases of IA [6 proven (3.4%) and 173 probable (96.6%)] were diagnosed in 3067 patients with acute leukaemia. The incidence of IA was 6.4% among 2440 AML patients and 3.8% among 627 ALL patients. Mortality at Day 84 was 33.8% (49/145) and attributable mortality was 26.9% (39/145). At Day 84, 53 patients (29.6%) showed a complete response, 25 (14.0%) a partial response and 17 (9.5%) a deterioration or failure. A total of 77 clinical Aspergillus fumigatus isolates were collected during the study period. Two episodes of azole-resistant IA (1.1%) were caused by a TR/L98H mutation in the cyp51A gene. With only two cases of IA due to azole-resistant A. fumigatus, a change of antifungal treatment practices in Germany does not appear warranted currently.
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Affiliation(s)
- Philipp Koehler
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Axel Hamprecht
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
| | - Oliver Bader
- Institut für Medizinische Mikrobiologie-Universitätsmedizin Göttingen, Göttingen, Germany
| | - Isabelle Bekeredjian-Ding
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Dieter Buchheidt
- Department of Haematology and Oncology, Mannheim University Hospital, University of Heidelberg, Mannheim, Germany
| | - Gottfried Doelken
- Friedrich Loeffler Institute for Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Johannes Elias
- Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Gerhard Haase
- Department of Haematology, Oncology, Haemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Corinna Hahn-Ast
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Meinolf Karthaus
- Medical Clinic IV, Haematology and Oncology, Neuperlach Hospital, Munich, Germany
| | - Alexander Kekulé
- Martin Luther University Halle-Wittenberg, Institute for Medical Microbiology, Halle (Saale), Germany
| | - Peter Keller
- University Hospital of Jena, Institute of Medical Microbiology, Jena, Germany
| | - Michael Kiehl
- Department of Haematology and Oncology, Klinikum Frankfurt Oder, Frankfurt, Germany
| | - Stefan W Krause
- Medizinische Klinik 5, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Carolin Krämer
- Department of Haematology, Oncology, Haemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Silke Neumann
- Institut für Medizinische Mikrobiologie-Universitätsmedizin Göttingen, Göttingen, Germany
| | - Holger Rohde
- Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Paul La Rosée
- University Hospital of Jena, Institute of Medical Microbiology, Jena, Germany
| | | | - Philippe Schafhausen
- Department of Internal Medicine II, Hubertus Wald Tumor Center-University Cancer Center Hamburg, Hamburg, Germany
| | - Enrico Schalk
- Department of Haematology and Oncology, Medical Center, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Katrin Schulz
- Friedrich Loeffler Institute for Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | | | - Gerda Silling
- Department A of Internal Medicine, University Hospital of Münster, Münster, Germany
| | - Peter Staib
- Klinik für Hämatologie und Onkologie, St Antonius Hospital Eschweiler, Eschweiler, Germany
| | - Andrew Ullmann
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany
| | | | - Thomas Weber
- Martin Luther University Halle-Wittenberg, Institute for Medical Microbiology, Halle (Saale), Germany
| | - Oliver A Cornely
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany; Clinical Trials Centre Cologne, ZKS Köln, Köln, Germany
| | - Maria J G T Vehreschild
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany.
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Schob S, Schicht M, Sel S, Stiller D, Kekulé A, Paulsen F, Maronde E, Bräuer L. The detection of surfactant proteins A, B, C and D in the human brain and their regulation in cerebral infarction, autoimmune conditions and infections of the CNS. PLoS One 2013; 8:e74412. [PMID: 24098648 PMCID: PMC3787032 DOI: 10.1371/journal.pone.0074412] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 08/01/2013] [Indexed: 01/05/2023] Open
Abstract
Surfactant proteins (SP) have been studied intensively in the respiratory system. Surfactant protein A and surfactant protein D are proteins belonging to the family of collectins each playing a major role in the innate immune system. The ability of surfactant protein A and surfactant protein D to bind various pathogens and facilitate their elimination has been described in a vast number of studies. Surfactant proteins are very important in modulating the host's inflammatory response and participate in the clearance of apoptotic cells. Surfactant protein B and surfactant protein C are proteins responsible for lowering the surface tension in the lungs. The aim of this study was an investigation of expression of surfactant proteins in the central nervous system to assess their specific distribution patterns. The second aim was to quantify surfactant proteins in cerebrospinal fluid of healthy subjects compared to patients suffering from different neuropathologies. The expression of mRNA for the surfactant proteins was analyzed with RT-PCR done with samples from different parts of the human brain. The production of the surfactant proteins in the brain was verified using immunohistochemistry and Western blot. The concentrations of the surfactant proteins in cerebrospinal fluid from healthy subjects and patients suffering from neuropathologic conditions were quantified using ELISA. Our results revealed that surfactant proteins are present in the central nervous system and that the concentrations of one or more surfactant proteins in healthy subjects differed significantly from those of patients affected by central autoimmune processes, CNS infections or cerebral infarction. Based on the localization of the surfactant proteins in the brain, their different levels in normal versus pathologic samples of cerebrospinal fluid and their well-known functions in the lungs, it appears that the surfactant proteins may play roles in host defense of the brain, facilitation of cerebrospinal fluid secretion and maintenance of the latter's rheological properties.
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Affiliation(s)
- Stefan Schob
- Institute of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- * E-mail:
| | - Martin Schicht
- Institute of Anatomy, Department II, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Saadettin Sel
- Department of Ophthalmology, University Heidelberg, Heidelberg, Germany
| | - Dankwart Stiller
- Institute of Forensic Medicine, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Alexander Kekulé
- Institute for Medical Microbiology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Friedrich Paulsen
- Institute of Anatomy, Department II, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Erik Maronde
- Institute of Anatomy, Department III, Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Lars Bräuer
- Institute of Anatomy, Department II, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
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Haase R, Voigt P, Kekulé A, Worlitzsch D, Schmidt F, Körholz D. Ergebnisse des mikrobiologischen Screenings auf einer neonatologischen Intensivstation: Retrospektive Analyse. Z Geburtshilfe Neonatol 2013; 217:56-60. [DOI: 10.1055/s-0033-1341451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- R. Haase
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Halle, Martin Luther Universität Halle
| | - P. Voigt
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Halle, Martin Luther Universität Halle
| | - A. Kekulé
- Institut für Medizinische Mikrobiologie, Universitätsklinikum Halle, Martin Luther Universität Halle
| | - D. Worlitzsch
- Institut für Hygiene, Universitätsklinikum Halle, Martin Luther Universität Halle
| | - F. Schmidt
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Halle, Martin Luther Universität Halle
| | - D. Körholz
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Halle, Martin Luther Universität Halle
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Urban S, Hildt E, Eckerskorn C, Sirma H, Kekulé A, Hofschneider PH. Isolation and molecular characterization of hepatitis B virus X-protein from a baculovirus expression system. Hepatology 1997; 26:1045-53. [PMID: 9328333 DOI: 10.1002/hep.510260437] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The X protein (HBx) of the human Hepatitis B Virus (HBV) is a regulatory protein that exercises a transcriptional activator function on a variety of regulatory elements and is therefore considered to be involved in the development of human hepatocellular carcinoma (HCC). So far, most attempts at elucidating HBx function have been undertaken at the genetic level, reflecting the difficulties in detecting the very low amounts of the protein in infected livers. Consequently, the questions of intracellular localization and posttranslational modification have not yet been completely answered. We therefore constructed recombinant baculoviruses that allowed expression of HBx and the hexa histidine HBx fusion protein HBxHis in insect cells. Cell fractionation experiments revealed that only a minor part of HBx is detectable in a soluble form in the cytosolic fraction, whereas most of the protein forms intracellular aggregates. These results could be confirmed by confocal laser immunofluorescence. The fusion of a hexa-histidine tag to the amino terminus of HBx allowed a rapid one-step purification by metal chelate affinity chromatography. The detailed analysis of purified HBxHis using electrospray ionization mass spectrometry uncovered two major components: the unmodified, monomeric, fully oxidized form with five intramolecular disulfide bridges, and its N-acetylated modification. Additionally, two minor peaks with mass differences of delta m = +80 da suggested that a small fraction of HBx becomes posttranslationally phosphorylated in insect cells. No further modifications could be observed, indicating that only phosphorylation might play a role in a possible posttranslational regulation of this viral activator.
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Affiliation(s)
- S Urban
- Department of Virus Research, Max-Planck-Institut für Biochemie, München, Germany
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